Biomedical subjects

Janette Vardy

Publications and source records attributed to Janette Vardy.

4 recordsLinked to original sources

PubMed2006

The effects of the anti-cancer drugs, methotrexate and 5-fluorouracil, on cognitive function in mice.

There is evidence that standard-dose chemotherapy may impact cognitive function in cancer patients. The present study evaluated the effects of a combination of two anti-cancer drugs, methotrexate (37.5 mg/kg) and 5-fluorouracil (5FU, 75 mg/kg) on cognitive function in a mouse model. Drug-induced deficits were observed in adult BALB/C mice on tests of spatial memory, non-matching-to-sample (NMTS) learning and in a delayed-NMTS test of non-spatial memory. There were no group differences on tests of cued memory or discrimination learning. Performance-related variables were ruled out as possible explanations of the observed impairments. The impaired performance of the drug group, which was consistent with cognitive deficits observed in human cancer patients treated with similar types of chemotherapy, was attributed to functional changes in specific brain regions, including the frontal lobes and hippocampus.

Animals↗

PubMed2006

Assessing cognitive function in cancer patients.

GOALS OF WORK: Some patients with cancer suffer cognitive impairment after chemotherapy. A brief, sensitive instrument is required to screen patients for cognitive impairment. In this study, we compare three possible screening instruments. MATERIALS AND METHODS: Cancer patients (n=31) who had received adjuvant chemotherapy within 2 years underwent cognitive evaluation on three occasions. Fluent English speakers (n=20) completed the High Sensitivity Cognitive Screen (HSCS), the computer-based Headminder and CogHealth, and the Functional Assessment of Cancer Therapy-cognitive function (FACT-COG) questionnaire. Patients not fluent in English (NESB) (n=11) performed CogHealth and Headminder. RESULTS: The patients were aged 31-65 years, and 94% were women with breast cancer. At baseline, 6 of 20 (30%) had moderate-severe cognitive impairment on HSCS, 17 of 31 (55%) had scores greater than one standard deviation (SD) below the mean for normative data in one to two of three domains on Headminder, and on CogHealth, 8 of 31 (26%) were greater than one SD below the mean in at least two of six domains. A large practice effect was seen for the HSCS, with moderate-severe cognitive impairment decreasing from 30 to 5% between the first and second assessment. On FACT-COG, 9 of 19 patients (47%) rated their cognition as greater than one SD below that of a pre-chemotherapy breast cancer control group, with impact on quality of life greater than one SD below for 10 of 19 (53%) patients. No correlation was seen between objective cognitive testing and the FACT-COG. CONCLUSIONS: CogHealth and Headminder were suitable for NESB patients. The HSCS is not recommended for longitudinal studies with short intervals between testing due to practice effect. There is poor correlation between the patients' perception of their cognitive impairment and the objective tests.

Adult↗

PubMed2004

Acetaminophen (paracetamol) improves pain and well-being in people with advanced cancer already receiving a strong opioid regimen: a randomized, double-blind, placebo-controlled cross-over trial.

PURPOSE: To determine whether adding regular acetaminophen (paracetamol) could improve pain and well-being in people with advanced cancer and pain despite strong opioids. PATIENTS AND METHODS: Participants took acetaminophen for 48 hours and placebo for 48 hours. The order (acetaminophen or placebo first) was randomly allocated. Pain was the primary outcome. Preferences, number of opioid breakthrough doses, overall well-being, nausea and vomiting, drowsiness, constipation, and cold sweats were secondary outcomes. Patients rated themselves daily with visual analog scales (VAS) and a verbal numeric scale (VNS) for pain, all scaled from 0 to 10. RESULTS: Thirty patients completed the trial. The oral opioid was morphine in 23 patients and hydromorphone in seven patients. The median daily opioid dose in oral morphine equivalents was 200 mg (range, 20 to 2,100 mg). Nonsteroidal anti-inflammatory drugs, corticosteroids, or both were used by 16 patients. Pain and overall well-being were better for patients receiving acetaminophen than for those receiving placebo. The mean difference was 0.4 (95% CI, 0.1 to 0.8; P =.03) in VNS for pain, 0.6 (95% CI, -0.1 to 1.3; P =.09) in VAS for pain, and 0.7 (95% CI, 0.0 to 1.4; P =.05) in VAS for overall well-being. More patients preferred the period they took acetaminophen (n = 14) than the period they took placebo (n = 8), but many had no preference (n = 8). There were no differences in the other outcomes. CONCLUSION: Acetaminophen improved pain and well-being without major side effects in patients with cancer and persistent pain despite a strong opioid regimen. Its addition is worth considering in all such patients.

Acetaminophen↗

PubMed2002

Life-threatening anaphylactoid reaction to amifostine used with concurrent chemoradiotherapy for nasopharyngeal cancer in a patient with dermatomyositis: a case report with literature review.

Dermatomyositis is associated with malignancy in approximately 20-25% of cases. The most common associated cancers are ovarian, lung, pancreatic, stomach, colon and non-Hodgkin's lymphoma. Nasopharyngeal cancer is not common in the Caucasian population; however, there is a much higher incidence in Asian patients. Radiotherapy is the mainstay of treatment for early nasopharyngeal cancer, but combination chemoradiotherapy is becoming more common for patients with advanced disease since the Intergroup trial 0099 demonstrated improved progression-free survival and overall survival for chemoradiotherapy. Increasingly, the cytotoxic agent amifostine is being used prior to radiotherapy in an attempt to decrease associated morbidities. Amifostine has been found to significantly decrease acute and chronic xerostomia but not mucositis. It appears to be selectively protective to salivary glands and kidneys without being tumor protective. The most common side effects associated with amifostine are nausea, vomiting, hypotension, hypocalcemia and allergic reactions. We describe the case of a man with dermatomyositis and stage IV nasopharyngeal cancer treated with chemoradiotherapy and s.c. amifostine. The patient suffered a life-threatening anaphylactoid reaction to amifostine.

Amifostine↗